scholarly journals Nasomaxillary Swing - A Novel Approach for Bilateral Angiofibroma

2009 ◽  
Vol 2 (3) ◽  
pp. 33-36 ◽  
Author(s):  
Alok Thakar ◽  
Gaurav Gupta ◽  
Mohnish Grover
Keyword(s):  
High Risk ◽  
Infratemporal Fossa ◽  
Complete Removal ◽  
Adolescent Males ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Nasopharyngeal Angiofibroma ◽  
Surgical Exposure ◽  
Novel Approach ◽  
High Risk Tumor

Abstract Juvenile nasopharyngeal angiofibroma (JNA) is a high-risk tumor of adolescent males. Choice of the approach should be based on the stage and site of the lesion. For complete removal of tumor, surgical exposure must be adequate. We here present a case of nasopharyngeal angiofibroma with intracranial and bilateral infratemporal fossa extension in which tumor was completely excised by nasomaxillary swing approach.

In defence of transpalatal, transpalatal-circumaxillary (transpterygopalatine) and transpalatal-circumaxillary-sublabial approaches to lateral extensions of juvenile nasopharyngeal angiofibroma

2016 ◽  
Vol 130 (5) ◽  
pp. 462-473 ◽  
Author(s):  
A Mishra ◽  
S C Mishra ◽  
V Verma ◽  
H P Singh ◽  
S Kumar ◽  
...  
Keyword(s):  
Residual Disease ◽  
Tumour Size ◽  
Infratemporal Fossa ◽  
Pterygopalatine Fossa ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Atrophic Rhinitis ◽  
Complete Excision ◽  
Nasopharyngeal Angiofibroma ◽  
Transpalatal Approach ◽  
Sublabial Approach

AbstractBackground:Juvenile nasopharyngeal angiofibroma often presents with lateral extensions. In countries with limited resources, selection of a cost-effective and least morbid surgical approach for complete excision is challenging.Methods:Sixty-three patients with juvenile nasopharyngeal angiofibroma, with lateral extensions, underwent transpalatal, transpalatal-circumaxillary (transpterygopalatine) or transpalatal-circumaxillary-sublabial approaches for resection. Clinico-radiological characteristics, tumour volume and intra-operative bleeding were recorded.Results:The transpalatal approach was suitable for extensions involving medial part of pterygopalatine fossa; transpalatal-circumaxillary for extensions involving complete pterygopalatine fossa, with or without partial infratemporal fossa; and transpalatal-circumaxillary-sublabial for extensions involving complete infratemporal fossa, even cheek or temporal fossa up to zygomatic arch. Haemorrhage was greatest with the transpalatal-circumaxillary-sublabial approach, followed by transpalatal approach and transpalatal-circumaxillary approach (1212, 950 and 777 ml respectively). Tumour size (volume) was greatest with the transpalatal-circumaxillary approach, followed by transpalatal-circumaxillary-sublabial approach and transpalatal approach (40, 34 and 29 mm3). There was recurrence in three cases and residual disease in two cases. Long-term morbidity included small palatal perforation (n = 1), trismus (n = 1) and atrophic rhinitis (n = 2).Conclusion:These modified techniques, performed with endoscopic assistance under hypotensive anaesthesia, without embolisation, offer a superior option over other open procedures with regard to morbidity and recurrences.

scholarly journals Recurrent and residual juvenile angiofibromas

2007 ◽  
Vol 121 (5) ◽  
pp. 460-467 ◽  
Author(s):  
I Tyagi ◽  
R Syal ◽  
A Goyal
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Internal Carotid ◽  
Complete Removal ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Residual Tumour ◽  
Nasopharyngeal Angiofibroma ◽  
Cavernous Sinus Invasion ◽  
Pterygoid Canal ◽  
Infratemporal Approach

Introduction: In the surgical management of juvenile nasopharyngeal angiofibromas the possibility of recurrences and residual tumours is always there. This study was undertaken to predict the prognostic factors determining recurrence of juvenile nasopharyngeal angiofibroma and to find out the usual sites of these tumours.Material and methods: The medical records of 95 patients with histologically proven juvenile nasopharyngeal angiofibroma were reviewed retrospectively. The commonest surgical approach used was a combined transpalatal and transmaxillary approach with a lazy S incision. A conservative lateral infratemporal approach was used in three cases.Results: Complete removal of the juvenile nasopharyngeal angiofibroma was achieved in 78 (82 per cent) of the cases in a single operation. A residual tumour was found in 17 (18 per cent) cases and recurrences occurred in 13 (13.7 per cent) cases.Conclusions: Extensions into the pterygoid fossa and basisphenoid, erosion of the clivus, intracranial extensions medial to the cavernous sinus, invasion of the sphenoid diploe through a widened pterygoid canal, feeders from the internal carotid artery, a young age and a residual tumour were risk factors found associated with recurrence of juvenile nasopharyngeal angiofibroma.

Juvenile nasopharyngeal angiofibroma with intracranial extension – diagnosis and treatment.

2019 ◽  
Vol 73 (6) ◽  
Author(s):  
Wiesław Gołąbek ◽  
Anna Szymańska ◽  
Marcin Szymański ◽  
Elżbieta Czekajska-Chehab ◽  
Tomasz Jargiełło
Keyword(s):  
Infratemporal Fossa ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Intracranial Extension ◽  
Radiological Findings ◽  
Superior Orbital Fissure ◽  
Nasopharyngeal Angiofibroma ◽  
Therapeutic Modalities ◽  
Stage Ivb ◽  
Extensive Involvement

Introduction This retrospective study analyzes radiological findings, therapeutic management and outcomes of patients with intracranial extension of juvenile nasopharyngeal angiofibroma (JNA). The routes of intracranial spread, incidence of intracranial disease and influence on therapeutic approach are discussed. Material and methods An evaluation on the records of 62 patients with JNA was performed and 10 patients with intracranial tumors were included in the study. All patients were males aged 10 to 19 years. Results According to Andrews' classification 8 patients presented with stage IIIb, 1 patient stage IVa and another patient stage IVb tumor. Intracranial invasion was extradural in 8 cases and intradural in 2 patient. Surgery was performed in 9 cases and the most common was combined approach: infratemporal fossa and sublabial transantral. One patient was referred for radiotherapy. Follow-up ranged from 8 to 26 years. There was extracranial recurrence in 2 (22%) of 9 operated patients. Conclusions The superior orbital fissure is the most frequent route of intracranial spread in patients with extensive involvement of the infratemporal fossa. Due to high risk of recurrence and potential serious complications advanced cases of JNA should be managed by experienced multidisciplinary team, preferably in tertiary referral centers, with an access to modern diagnostic and therapeutic modalities.

scholarly journals Surgical management of juvenile nasopharyngeal angiofibroma using lateral rhinotomy: study of 80 cases

2011 ◽  
Vol 1 (2) ◽  
pp. 34
Author(s):  
Ninad Gaikwad ◽  
Nilam Sathe ◽  
Abhijeet Bhatia ◽  
Dhanashree Chiplunkar ◽  
Manoj Patil
Keyword(s):  
Infratemporal Fossa ◽  
The Body ◽  
The Other ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Lateral Rhinotomy ◽  
Temporal Fossa ◽  
Nasopharyngeal Angiofibroma ◽  
Lateral Skull Base ◽  
Operative Complications

A series of 80 patients with histopathologically confirmed juvenile nasopharyngeal angiofibroma were treated surgically over a period of ten years (1995-2004). The lateral rhinotomy approach was used to expose the tumor and its extensions. Lateral rhinotomy with its extensions provides wide exposure of and access to the nose, nasopharynx, paranasal sinuses, pterygopalatine fossa, infratemporal fossa and temporal fossa. Most intracranial, extradural extensions can also be approached. There were no major operative or post-operative complications. Longterm follow up from one to ten years showed only 8 recurrences. The added advantage of this approach is that it can be combined with all the other anterior and lateral skull base approaches. The cosmetic outcome is satisfactory if nasal aesthetic subunits are taken into considerations while making the incision. The lateral rhinotomy approach is the most direct route to the body of the tumor and can be used to approach all the possible extensions of the tumor.

scholarly journals Nasal Septal Angiofibroma

2021 ◽  
pp. 014556132110265
Author(s):  
Oratile Thobejane ◽  
Shivesh Maharaj
Keyword(s):  
Computed Tomography ◽  
Clinical Presentation ◽  
Vascular Tumor ◽  
Adolescent Males ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Computed Tomography Scan ◽  
Excessive Bleeding ◽  
Nasopharyngeal Angiofibroma ◽  
Extranasopharyngeal Angiofibroma ◽  
Tomography Scan

Juvenile nasopharyngeal angiofibroma is a benign vascular tumor seen predominantly in adolescent males in the second decade of life. Extranasopharyngeal angiofibroma includes vascular fibrous masses that occur outside the nasopharynx. The diagnosis of an angiofibroma is based on the clinical presentation and imaging, with biopsies being avoided to avoid excessive bleeding. Computed tomography scan is considered sufficient for the diagnosis of extranasopharyngeal angiofibroma as it clearly delineates and identifies the tumor.

Transnasal microscopic approach for juvenile nasopharyngeal angiofibroma

2018 ◽  
Vol 72 (5) ◽  
pp. 31-36 ◽  
Author(s):  
Wiesław Gołąbek ◽  
Anna Szymańska ◽  
Kamal Morshed
Keyword(s):  
Infratemporal Fossa ◽  
Surgical Excision ◽  
Vascular Tumor ◽  
Stage I ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Preoperative Embolization ◽  
Stage Iiia ◽  
Nasopharyngeal Angiofibroma ◽  
Feeding Vessels

Introduction: Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign, vascular tumor originating in the nasopharynx. The treatment of choice for JNA is surgical excision. In recent years, surgical management has been greatly influenced by the use of the transnasal endoscopic technique. The aim: The aim of the study was to present our experience with the transnasal microscopic removal of JNA. Material and methods: Ten patients with JNA aged 12-17 underwent diagnostics imaging and transnasal microscopic tumor excision. Medical records of patients were retrospectively reviewed. The main outcome measures were complications and recurrences. Preoperative embolization of feeding vessels was performed in 7 patients. Results: According to Andrews’ classification, the group included 2 stage I patients, 6 stage II patients and 2 stage IIIA patients with the extensive occupation of the infratemporal fossa. 9 patients had no recurrence in 6-11 years follow up. One stage IIIA patient had a recurrence posteriorly to the pterygopalatine process and it was completely removed. No complications during or after surgery occurred. Conclusion: Transnasal microscopic excision is an effective approach to resect stage I-IIIA JNA

scholarly journals Juvenile Nasopharyngeal Angiofibroma: Correlating Histology, Surgical Approach and Blood Loss

2015 ◽  
Vol 8 (2) ◽  
pp. 47-52
Author(s):  
RG Aiyer ◽  
Rahul R Gupta ◽  
Prarthna J Jagtap ◽  
Tanuj Thapar
Keyword(s):  
Blood Loss ◽  
Surgical Approach ◽  
Surgical Excision ◽  
Complete Removal ◽  
Vascular Tumor ◽  
Growth Patterns ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
Nasopharyngeal Angiofibroma

ABSTRACT Juvenile nasopharyngeal angiofibroma (JNA) is locally destructive benign vascular tumor for which surgical excision has always been the treatment of choice, in spite of the availability of various other treatment modalities. Complete removal at the maiden attempt has always been the key to a successful outcome. Recurrences (or rather residuals) discourage both the surgeon and patient. This prospective study was carried out in the Department of Otorhinolaryngology, Sir Sayajirao General Hospital, Vadodara, Gujarat, between August 2002 and 2015. We have studied 28 patients with JNA for growth patterns, histological characteristics and to compare various surgical modalities. Besides other investigations a detailed histological examination of the tumor was performed which suggested that as the tumor ages, the stroma predominates and the vessels are compressed into slits. In actively growing tumor the vascular component predominates. The percentage of open vascular channels is directly proportional to the bleeding while the intervascular fibrosis is inversely related. Surgical excision of JNA is the preferred modality of treatment. Surgical approach is sometimes the most tricky decision. Choosing the right approach is akin to walking on the thin rope with adequate exposure on one side and postoperative scar on the other. How to cite this article Thapar T, Gupta RR, Jagtap PJ, Aiyer RG. Juvenile Nasopharyngeal Angiofibroma: Correlating Histology, Surgical Approach and Blood Loss. Clin Rhinol An Int J 2015;8(2):47-52.

Surgery for juvenile nasopharyngeal angiofibroma with lateral extension to the infratemporal fossa

2014 ◽  
Vol 41 (4) ◽  
pp. 359-363 ◽  
Author(s):  
Masato Yamada ◽  
Atsunobu Tsunoda ◽  
Takao Tokumaru ◽  
Masaru Aoyagi ◽  
Yoshihisa Kawano ◽  
...  
Keyword(s):  
Infratemporal Fossa ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Lateral Extension ◽  
Nasopharyngeal Angiofibroma
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